CON Request for Waiver of Faculty Immunizations or CPR Requirements: Difference between revisions

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         <td width="60%"><big>'''Request for Waiver of Faculty Immunizations or CPR Requirements'''</big>(Subsection 4.2.12 in Resource Manual)</td>
         <td width="60%"><big>'''Request for Waiver of Faculty Immunizations or CPR Requirements'''</big></td>
         <td valign="top" width="40%"><big>Subsection: '''Appendix M'''</big></td>
         <td valign="top" width="40%"><big>Subsection: '''Appendix M'''</big></td>
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                 <td>Revised: [[CON Request for Waiver of Faculty Immunizations or CPR Requirements version February 2008|February 2008]]<br />Reviewed: [[CON Request for Waiver of Faculty Immunications or CPR Requirements version May 2016|May 2016]]<br />Revised: March 2018</td>
                 <td>Revised: [[Special:PermanentLink/7712|February 2008]]<br />Reviewed: [[Special:PermanentLink/11099|May 2016]]<br />Revised: March 2018 ([[Special:Diff/11099/{{REVISIONID}}|changes]])</td>
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    <td>_______________________________________________</td>
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    <td>_______________________________</td>
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    <td>Department Chair/Division Assistant Dean Signature</td>
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    <td>Date</td>
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<tr><td colspan="3">Submit completed/signed form to conrecords@unmc.edu</td></tr>
<tr><td colspan="3">Submit completed/signed form to conrecords@unmc.edu</td></tr>
<tr><td colspan="3">&nbsp;</td></tr>
<tr><td colspan="3">&nbsp;</td></tr>

Latest revision as of 13:49, June 12, 2024

Home   Appendices                    


UNIVERSITY OF NEBRASKA MEDICAL CENTER
COLLEGE OF NURSING
Request for Waiver of Faculty Immunizations or CPR Requirements Subsection: Appendix M
Section - Appendices Originating Date: October 2003
Responsible Reviewing Agency:
Executive Council
Faculty Coordinating Council
Revised: February 2008
Reviewed: May 2016
Revised: March 2018 (changes)
Related documents:
4.2.12


I, ________________________________________________, request a waiver of requirements for the following immunization(s) and/or CPR (please list):

for the following reason(s) (ex. allergy):

_______________________________________________   _______________________________
Faculty Signature   Date
 
Submit completed/signed form to conrecords@unmc.edu
 
Note: For recurring requirements, form should be submitted each time requirements comes due.
 
Retrieved from "https://wiki.unmc.edu/index.php?title=CON_Request_for_Waiver_of_Faculty_Immunizations_or_CPR_Requirements&oldid=15988"